Psychiatria Fennica (Nov 2024)
ASSOCIATIONS BETWEEN PSYCHIATRIC MORBIDITIES AND IDENTITY DEVELOPMENT IN ADOLESCENTS WITH GENDER DYSPHORIA REFERRED TO SPECIALIZED GENDER IDENTITY SERVICES
Abstract
ABSTRACT Objectives: Establishing a stable identity is considered an important developmental task during adolescence. One salient identity domain is gender identity or the inner sense of gender. Gender dysphoria (GD) may occur when this inner sense of gender does not align with the sex registered at birth. Both poorer overall identity development and GD have been connected to mental health problems in adolescence. The aim of this study was to investigate the associations between mental health problems and identity development among adolescents with GD. Materials and methods: We conducted a study on 114 adolescents (94 birth-registered females and 20 birth-registered males, aged 12–18 (mean age (sd) 16.2 (0.1) years) seeking medical gender reassignment (GR) in specialized gender identity services in Finland. Identity development was measured in terms of “impaired personality functioning” with the 58-item self-report questionnaire Assessment of Identity Development in Adolescence (AIDA). Psychiatric morbidity was assessed by reference to previous psychiatric treatment history, ICD-10 psychiatric diagnoses and psychiatric symptoms recorded in the participants’ case histories before and during the gender identity assessment. The data were analysed using cross-tabulations with chi-square statistics and t-test, and multivariate associations using linear and logistic regression as appropriate. Results: Contrary to our expectations, the AIDA scores were not associated with psychiatric morbidity variables. We suggest that it is, thus, imperative to conduct a comprehensive and holistic evaluation of adolescents seeking medical GR, not relying solely on self-reports. However, higher AIDA scores indicating poorer identity development were connected to not being considered eligible for medical GR. Conclusions: The inclusion of identity development self-assessment can only provide some indications on overall maturity and preparedness for medical GR.
